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Individual
DR. CODY BOYER JACKSON
Active
Individual
DR. CODY BOYER JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD, PHD
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD223559
OR
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
MT237978
PA
207RP1001X
Pulmonary Disease Physician
MT237978
PA
208D00000X
General Practice Physician
Primary
MD223559
OR
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/21/2023
Last updated
07/08/2026
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